| NPI | 1851735534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: TX 12231) |
| Additional Taxonomies | 111NI0013X Chiropractor, Independent Medical Examiner (Licence: TX 12231) |
| 111NS0005X Chiropractor, Sports Physician (Licence: TX 12231) | |
| 111NX0100X Chiropractor, Occupational Health (Licence: TX 12231) | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |